Correct Answer: A

Rationale: The purpose of a tracheostomy is to establish an artificial airway in the trachea through a surgical procedure. This is done to bypass obstructions in the upper airway, assist with breathing, or facilitate the removal of secretions from the lungs. A tracheostomy helps in maintaining a clear and secure airway for patients who have difficulty breathing or require long-term mechanical ventilation support.

Correct Answer: C

Rationale: Choosing option C, asking the patient about their cultural beliefs and preferences related to pain, demonstrates cultural competence in pain assessment. Pain experiences can vary greatly across different cultures, and a patient's cultural background can influence how they perceive and express pain. By inquiring about the patient's cultural beliefs and preferences, the nurse can gain a better understanding of the patient's perspective on pain. This information is crucial for providing individualized and culturally sensitive pain management interventions. It also shows respect for the patient's unique cultural background and helps build a trusting and collaborative relationship between the nurse and the patient.

Correct Answer: A

Rationale: The described presentation is classic for acute angle-closure glaucoma. This condition is characterized by sudden-onset severe eye pain, headache, nausea, and vomiting. The red eye, steamy cornea (corneal edema), and mid-dilated non-reactive pupil are consistent with acute angle-closure glaucoma. The sudden increase in intraocular pressure leads to impaired aqueous humor outflow, causing these symptoms. Immediate intervention is required to prevent permanent vision loss in such cases. Central retinal artery occlusion would present with sudden painless vision loss. Optic neuritis typically presents with vision loss and pain with eye movements. Corneal ulcer presents with eye discomfort, foreign body sensation, and may have a history of corneal trauma or contact lens wear.

Correct Answer: D

Rationale: The first step Nurse Gabriela should do when handling vaccines is to check the vial for the expiration date. It is crucial to ensure that the vaccine has not expired before proceeding with any further steps. Administering an expired vaccine can be ineffective or even harmful to the patient. Therefore, checking the expiration date is the foundational step in the safe and proper administration of vaccines.

Correct Answer: B

Rationale: In the community setting, the essential record about the patient is the patient's chart. This chart contains all important information about the patient, including medical history, treatment plans, medications, progress notes, and any other pertinent information related to the patient's care. It serves as a crucial document for healthcare providers to track and monitor the patient's health status, facilitate communication among team members, ensure continuity of care, and make informed clinical decisions. The patient's chart is a comprehensive and centralized source of information that guides the delivery of quality care in the community setting.